Yet on 31 March 2008 after eight days without the medication for his schizophrenia, the popular sociable 36-year-old turned up at the family home in Liverpool, convinced by voices he heard, and killed his parents.

His mother Stella, 63, was stabbed 37 times and his father - also called Alan - was stabbed 13 times. Scott admitted manslaughter on grounds of diminished responsibility.

His sisters Christine Walker and Collette McCormick, have no doubt that failures in his care, especially staff shortages led to the catastrophe.

Alan Scott, who had been treated for his condition for more than a decade as an out patient, missed an appointment on 24 March 2008 to receive his monthly injection of the drug Depixol.

Collette said: "He turned up later and was told staff were in a meeting and was told to come back next day, he came back the next day and was too early as there was nobody qualified to give him the injection."

He left a phone message with his care co-ordinator to bring the medication to his home on 31 March, but the co-ordinator did not turn up. By the evening of the same day his parents were lying in a pool of blood.

Having read the confidential report into their brother's case, the sisters say it clearly identifies a shortage of skilled staff as one of the factors which led to his mental deterioration in the days before their parents' death.

Christine Walker sees flaws in her brother's care: "He did not have a psychiatric assessment for three and a half years, he had been allowed to lower his medication and nothing was noted on the system as to why he was allowed to lower his medication.

"Obviously that medication wasn't enough for him."

Her sister added: "He was let down in many areas, because his care co-ordinator had a lot of sick leave and he should have been passed onto another team, which he never was."

Government pledge

Mersey Care NHS Trust, which was responsible for his treatment, said: "Alan Scott was a long term patient of the trust's community service and had received ongoing care and treatment over many years.

Alan Scott left his parents in a pool of blood in their home

"Issues governing patient confidentiality make it difficult for us to go into the exact details of his condition or treatment."

The trust would would not give File on 4 a breakdown of its staff levels, saying it was confidential.

The government is adamant that it has enough teams in place to manage outpatient care.

Care Services Minister Phil Hope told File on 4, "We have increased funding for mental health services by 50% - some extra £2bn over the lifetime of our National Service Framework.

"There are more staff providing better services to people in the community to help those patients who experience mental health problems."

'Care gaps'

But Dr JS Bamrah, chair of the British Medical Association's psychiatric sub-committee, said a survey of his members revealed that while there may be enough community care teams, that does not mean they are staffed adequately.

"We're ostensibly in a good position because over the last few years there has been a gradual increase in spend.

"From the outside it looks good, the government has set up crisis resolution and home treatment teams which are wonderful and they work extremely hard but they cannot plug the gap for the level of work that is required.

"There are gaps within the teams, recruitment has been a big problem and there are not enough staff to do the work that is required for the level of illness in the community."

BBC links

This page is best viewed in an up-to-date web browser with style sheets (CSS) enabled. While you will be able to view the content of this page in your current browser, you will not be able to get the full visual experience. Please consider upgrading your browser software or enabling style sheets (CSS) if you are able to do so.